HomeMy WebLinkAboutBuilding Permit 99-1016
cJ$ TIME
CITY OF PRIOR LAKE Ar
INSPECTION NOTICE SCHEDULED I 'Zoo" 'f<f
ADDRESS (SL/g I-kY l;" V;~
OWNER CONTR.
PHONE NO. PERMIT NO. Cf9- lo/Co
o FOOTING
o FOUNDATION
o FRAMING
~INSULAT~liV
I" FINAL f\"
o SITE INS ION
COMMENTS: f!..ooJ
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
P/t!Y,8;
L,~Fic-b
!XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND RqCEED
o CORRECT WORK, t- O~ REINSPECTION BEFORE COVERING
I (""r
Inspector: \ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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8/17 /~1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
File
City
Applicant
9C?-/O/b
Permit No.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
?? -/0 -iJ
PUSD
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
flqrbol
2. SITE ADJl!l~Sy /
b:J 'iP -b 5S'D
U/ew
3, LEGAL DESCRIPTION
2-
12. NO. OF STORIE]
BLOCK I PID 25 - 233- ()oz- 0
HAef',OIe... 4- 77f /!DDAJ. -t I {1 " \ 13,TYP^OfC~STRUj;lION f\
~ ..' H' r. . . ~ {~f' If't- /') I~ Oft.
(~dresS) tT<f ...-/1,_ - (Tel No,) .
/-J5S0c.- r ~i,;;,-1,;};;} -S'575'
(Address) (Tel. No.)
LOT
ADDITION
4..orNER/.
1:!!3" Oi':> r
5. ARCHITECT
(Name)
Con1/YlUIII
(Name)
14. FLOOR AREA APPORTIONMENT USE
+y
6. BUILDER.... (Name) R (Address) '0 (Tel. No.)
A"2..fec. IJ'Sf?3 ---pe r, ~'i5'"-OOiD
7. TY~~er,'n3 F"ep~~ r n~e~~ II ~eiJ1 rJ '-Re.roolin~ Porch"
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Rs-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, P~EO C!OS'DE 0
17, CUMPLETION DATE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19' PROPERTY DIMENSIONS 1'0. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~Uilding official can revoke this permit for just cause. Furthermore, I hereby agre~a(!)/j391 / a;:;Oee may enter upon the property to pertW ::ejo in~99s.
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS " ENERGY DATA "
PILING LOGS " PERCOLATION TESTS "
Side
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS D
SURVEY 0
SETS
COPIES
~ R.6S: /fIR..-
USE OF BUILDING
,
z"son.no
PLOT PLAN
"
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A 8 E F HIM R S U
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ........,........................,....... $
Collective Street Fee .... ................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................ .... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
City:
Division 1 2 3 4
Permit Fee ................................... $
74 75"
Plan Check Fee ................. ............ $
;,2-5
State Surcharge ............................. $
Penalty.................. ..................... $
Plumbing Permit Fee ....................... <t
Mechanical Permit Fee ..................... <t
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'.A'..
Sewer & Water Permit ...................... <t
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ..............,.,............. $ '""'1&.0 0
Paid 7t. 0 0 Receip~~ ~5B82-
Date '6//7 /q0 By -1JVIA.--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~nce and may proceed/s requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to ......',,,, ,g.....g. Before occupancy, a Certificate of Occupancy must be issued.
ng ;:t:'" W'n1trJ?1
I
Certificate of Occupancy
Issued
Date
City Planner
Special Conditions if any
24 hour notice for all inspections 447-9850